Smith-Peterson (Posterior) Osteotomy

Spinal deformities have been a common occurrence in today’s population, especially in elderly people. Aside from that, spinal deformities can arise from a number of causes and origins such as inflammatory, idiopathic and congenital. These deformities can be debilitating for the user to have, both functionally, physically, and psychologically.

Osteotomies are life-saving procedures that can remedy some of these severe spinal deformities. Currently, there are two types of osteotomies that are commonly in use in the medical field. Despite having different origins, these two osteotomies are used interchangeably.

• The first osteotomy is the Ponte-type osteotomy, a wide segmental osteotomy followed by posterior compressions along regions that are relatively unfused and are plagued with kyphotic deformity, most commonly in patients with Scheuermann’s kyphosis.
• The second one is the Smith Petersen Osteotomy, a technique utilizing the posterior (back) vertebral body (middle column) as the fulcrum to correct deformity through fused disc spaces.

In more simple terms, spine osteotomies, both Ponte type, and Smith Peterson are surgical procedures in which a certain section of the spinal bone is cut and then removed to allow for the correction of the alignment of the spine. Spine osteotomy is reserved for the correction of severely deformed, rigid and fixed spinal irregularities, where non-surgical processes don’t work.  Spine osteotomy is also used when the deformities get worse over time. The difference between the various spine osteotomies out there is both the location of the spinal deformity and the amount of surgery that is required to correct it.

What is the Purpose of the Procedure?

Smith Petersen Osteotomy serves the purpose of correcting spinal deformities in patients who require a small amount of correction. Smith Petersen Osteotomy also serves the purpose of correcting spinal deformity that occurs in conditions such as iatrogenic flat back, ankylosing spondylitis, Scheuermann’s kyphosis, and various neuromuscular, congenital and degenerative disorders.

Smith Petersen Osteotomy can effectively alleviate symptoms of early fatigue, subjective sense of imbalance, unbearable pain and a tendency to lean forward (stooping) that is common to these types of conditions. Lastly, a Smith Petersen Osteotomy can reduce pain in patients and restore their balance so that they are able to stand erect properly without putting much effort in flexing their knees and hips.

How to Prepare for the Procedure

There are certain precautions and preparations you can take if you are planning to undergo a Smith Petersen Osteotomy, in order to make the operation more successful. The preparations that you can take largely depend on what the doctor or surgeon will advise you to do, but in general, here are some useful tips you can use to prepare yourself for the procedure :

• Avoid Smoking Completely– for at least two weeks before undergoing the surgery and possibly a few months after. This may be difficult for smokers to do but smoking and the nicotine byproduct of the process can slow healing to a point that it increases the risk of deep vein thrombosis from happening. Deep vein thrombosis is a potentially deadly blood clot that can occur right after a surgery.
• Avoid Taking certain medications– this step largely depends on the advice of your physician. Medications such as NSAIDs and Aspirin should be avoided as they can make blood more difficult to clot, and may suppress the ability of the immune system to combat infection.
• Avoid drinking– for at least a week before surgery as alcohol can impair the effects of anesthesia from taking place.
• Take proper care of the area to be operated on– some measures that can be used to enforce this is the proper daily washing of the area where the procedure is to be performed so that chances of postoperative infection are decreased. Your doctor may choose to prescribe you specific antiseptics, or antimicrobial skin cleansers. These substances may also be used post-operation to take care of the wound.

The patient should also take special care that the skin around the area to be operated on should be free from irregularities and problems that can negatively affect it. Some of these problems include sunburns, scrapes, and even poison ivy wounds.

Procedure

Smith Petersen Osteotomy is done by surgically removing a small amount of the affected bone’s section from the back of the spine (posterior). This removal causes the spine to lean more toward the back. Other joints are also removed from this area, namely the facet and posterior ligament joints.

Results

With recent developments in the medical field, especially in the field of spinal surgical procedures, the results of Smith Petersen osteotomy have largely improved and have had fewer and fewer number of casualties throughout the years.

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